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ETHOS Linear Accelerator at DKFZ in Heidelberg



ETHOS (Varian, Palo Alto, CA, USA) at DKFZ in Heidelberg is a state-of-the-art radiation therapy device used for the treatment of various forms of cancer. It offers a wide range of advanced features and technologies, including artificial intelligence, which enable precise and personalized radiation therapy. ETHOS is equipped with a high-resolution imaging system that not only allows for precise patient positioning, but also enables it to perform "online adaptive radiotherapy." This means that an optimized, customized radiation plan can be created for each radiation session, resulting in more precise and gentle treatment.

Overall, ETHOS in Heidelberg provides an innovative and patient-centered solution for radiation therapy, supporting precise, safe, and effective cancer treatment.

Modular Adaptive Radiotherapy System (MARS)

Shuttle-based transport, beginning at the 3T MRI scanner

Despite improvements in computed-tomography imaging, magnetic resonance imaging (MRI) still provides superior soft tissue contrast. This offers the possibility to precisely distinct tumor tissue from heathy tissue. Hence, the Division E050 at DKFZ in Heidelberg developed the Modular Adaptive Radiotherapy System (MARS), which combines the online adaptive radiotherapy device ETHOS with a high-field MRI device (VIDA, Siemens, Erlangen, Germany). Both devices are connected via a patient shuttle (Symphony, CQ Medical, UK). Using MR imaging and shuttle-based patient transport, we investigate the possibility to further optimize adaptive radiotherapy by performing offline MR-guidance. The figure on the right-hand side illustrates the shuttle-based transport, beginning at the 3T MRI scanner. Afterwards, the patients are shuttled to the neighboring ETHOS device.

Both the ETHOS and the VIDA MRI scanner are kindly funded by the Dieter Morszeck Foundation.


Kim JY, Tawk B, Knoll,M, Hoegen-Saßmannshausen P, Liermann J, Huber PE, Lifferth M, Lang C, Häring P, Gnirs R, Jäkel O, Schlemmer HP, Debus J, Hörner-Rieber J, Weykamp F. Clinical Workflow of Cone Beam Computer Tomography-Based Daily Online Adaptive Radiotherapy with Offline Magnetic Resonance Guidance: The Modular Adaptive Radiotherapy System (MARS). Cancers 16(6), 1210 (2024) [10.3390/cancers16061210]

Weykamp F, Meixner E, Arians N, Hoegen-Saßmannshausen P, Kim JY, Tawk B, Knoll M, Huber P, König L, Sander A, Mokry T, Meinzer C, Schlemmer HP, Jäkel O, Debus J, Hörner-Rieber J. Daily AI-Based Treatment Adaptation under Weekly Offline MR Guidance in Chemoradiotherapy for Cervical Cancer 1: The AIM-C1 Trial. J. Clin. Med. 2024, 13(4), 957 []

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